Appointment Request

The first step toward achieving a beautiful, healthy smile is to schedule an appointment. To schedule an appointment, please complete and submit the request form below. Our scheduling coordinator will contact you soon to confirm your appointment.

Please note this form is for requesting an appointment. If you need to cancel or reschedule an existing appointment, or if you require immediate attention, please contact our practice directly.

Contact Information:

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Your NameFirst and LastYour Email Address:Your Phone NumberComment:

"The staff is always very friendly and able to answer all my questions. I drive 30 minutes to see you all, keep up the good work!" — Amber C.

"We drive from Shelby to Bucyrus to see you, that shows how pleased we are with you! Keep up the excellent work. " — Eric C.